Hempfield Ice Hockey Club, Inc.

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Claribel Boone
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Hempfield Ice Hockey Club, Inc. The Hempfield Ice Hockey Club, Inc. has the following fee schedule for the 2017-2018 hockey season. The fees are estimated to be $750.00 for 9 th -12 th Grade and $725.

Fifth grade students who register are allowed to play at the middle school level if there are slots available.

1 Hempfield Ice Hockey Club, Inc. The Hempfield Ice Hockey Club, Inc. has the following fee schedule for the hockey season. The fees are estimated to be $ for 9 th -12 th Grade and $ for 5 th -8 th Grade, and 25% off the second player in a family.*** These fees are determined by the number of players, and associated club fees ( such as CPIHL dues and cost of ice slots). Fifth grade students who register are allowed to play at the middle school level if there are slots available. In the event that the roster is full, 5 th graders who wish to register will be able to practice with the team for a reduced fee of $ for the season. You may mail your payments to:+ Hempfield Ice Hockey Club Inc. c/o Amy Ward 3187 Thistle Drive Lancaster, PA Date Due Amount May, 2017 $ September 1, 2017 $ October 1, 2017 $ November 1, 2017 Remaining balance (TBD) Amy will have a milk box on her porch containing an envelope for payments no cash please!! *** The fees do not include the cost of jerseys, socks or patches. Payment for uniforms must be made before order is placed. No Pay, No Play! If the payment is not received by each due date your son and daughter will not be allowed on the ice for practices or games until payment is made. Please contact a board member at the beginning of the season if a different payment plan is requested. Any requested payment plans will be voted on at the next scheduled board meeting. All fees are to be paid in-full before any Program Ad Fundraiser refunds are given. No exceptions. U.S.A. Hockey Registration! Please be aware that part of registration requires insurance information and membership to USA Hockey. The USA Hockey membership is not included in the packet as it is an online registration process. There is a fee for the membership and is valid from August 2017-August This is required for your player to be allowed on the ice. Please be prepared with this information when registering! Please note that even if you have a current USA hockey membership expiring in August, 2017, it must be renewed for the new hockey season in order to be rostered!!!!! You can renew your USA hockey membership beginning on April 1 st and it will still be valid for a full year beginning in August 2017.

2 PLEASE READ CAREFULLY AND PROVIDE ALL INFORMATION WHEN REGISTERING. Hempfield Ice Hockey Club, Inc. Player Registration Player Information: Last Name: First Name: Middle Initial: Street Address: City, State, Zip: Date of Birth: (MM/DD/YYYY) Home Phone: School and Grade for school year: HHS CMS LMS LIC CES EPES FES MES RES Height: Weight: Player s address: Player s Mobile Phone: Previous Hockey Experience: (Please list all teams and level House, B, A, AA, or school) Team playing for in school year: Team Played for in school year: Team Played for in school year: Team Played for in school year: Team Played for in School year: Current Hempfield Jersey Number: Parent Information: Please indicate ALL s you would like included on the list!!!!! Father or Guardian 1 Name: Mobile Phone: Work Phone: Address: Mother or Guardian 2 Name: Mobile Phone: Work Phone: Address:

3 Items needed for completed Registration are listed below: (please return ALL of these items to the club at the registration meeting. PLEASE READ CAREFULLY AS THERE ARE SOME CHANGES.) If you are unable to attend, they MUST be submitted BEFORE June 15, 2017.) If registrations are not received by 6/30/17 with ALL of the necessary information/ forms, the player will be ineligible and your deposit is non-refundable. Participant checklist Form or Item needed Registration Form (this 2 page form) Waiver of Liability (signed by parent and student) USA Hockey Consent to Treat (Fully completed) USA Hockey Registration Receipt (must register online at - there is a fee) UNDERSTANDING OF RISK OF CONCUSSION AND TRAUMATIC BRAIN INJURY Hempfield School District Substance Use Regulations (JV and Varsity only signed by student and parent) Non Refundable Deposit of $ Payable to Hempfield Ice Hockey Club, Inc. Club Use Only ONLY NEW PLAYERS: Copy of Birth Certificate and in September, a copy of the student ID with your skater's picture and year clearly visible. Notes for club use: For questions, please call Amy Ward at There will be a mandatory parent meeting in August.

4 Uniform Information & Fees Player s last name (print neatly as you want it to appear on the Jersey) Returning player from last year: Jersey number Items needed Size needed I did not play last year and need to order a set I need a pair of hockey socks Circle Size and color needed Warm-up Jacket (optional) Size needed and list 3 numbers you would like to have in order of preference Size Numbers Small Black or White Medium Black or White Large Black or White Adult: Small Medium Large XLarge Jersey Sizes are Adult Small, Medium, Large, X-Large and 2 X-Large - no Goalie Cut available Please see Jersey Number Chart on the next page for the list of numbers currently in use. Uniform fees are due prior to placing order. $120 ($60 each for Home and Away Jersey) $10 for 1 pair of leg socks. $60 Warm-up Jacket *** Jerseys and Socks can be worn for as many years as they fit! Additional Optional Fees: Order forms for spirit wear and varsity jackets will be distributed in the fall for mid-december delivery. Team and Individual Photos will be done at the beginning of the season.

5 Current Hempfield Jersey Numbers as of Jersey Player Number 1 Joshua Gusst 12 2 Elias Lountzis 10 3 Mason Groff 12 4 Cooper Younger 11 5 Darrion Skaggs 10 7 Rachel Martin 9 8 Theodore Lountzis 8 9 Aadyn Riley 7 10 Ian Farmer Nathan Matthews Kye Dunigan Casey Strodoski Mariah Groff Carter Lutter 8 16 Anthony Arters Greg Lenker Jake Rannels Quin Anderson Tom Kissinger Jared Cheyney Paige Basler Damian Mitchell 9 24 Austin Bole Max Aukamp Jackson Younger 7 44 Luke Phillips Jacob Gusst Bryan Ernst Aidan Miller Reese Witmer 7 57 Michael Nguyen Brenden Ward Evan Weaver Chris Grubb David Ward 7 91 Zakery Meshey 12 Grade

8 Revised: March 22, 2012 SECTION 3: UNDERSTANDING OF RISK OF CONCUSSION AND TRAUMATIC BRAIN INJURY What is a concussion? A concussion is a brain injury that: Is caused by a bump, blow, or jolt to the head or body. Can change the way a student s brain normally works. Can occur during Practices and/or Contests in any sport. Can happen even if a student has not lost consciousness. Can be serious even if a student has just been dinged or had their bell rung. All concussions are serious. A concussion can affect a student s ability to do schoolwork and other activities (such as playing video games, working on a computer, studying, driving, or exercising). Most students with a concussion get better, but it is important to give the concussed student s brain time to heal. What are the symptoms of a concussion? Concussions cannot be seen; however, in a potentially concussed student, one or more of the symptoms listed below may become apparent and/or that the student doesn t feel right soon after, a few days after, or even weeks after the injury. Headache or pressure in head Nausea or vomiting Balance problems or dizziness Double or blurry vision Bothered by light or noise Feeling sluggish, hazy, foggy, or groggy Difficulty paying attention Memory problems Confusion What should students do if they believe that they or someone else may have a concussion? Students feeling any of the symptoms set forth above should immediately tell their Coach and their parents. Also, if they notice any teammate evidencing such symptoms, they should immediately tell their Coach. The student should be evaluated. A licensed physician of medicine or osteopathic medicine (MD or DO), sufficiently familiar with current concussion management, should examine the student, determine whether the student has a concussion, and determine when the student is cleared to return to participate in interscholastic athletics. Concussed students should give themselves time to get better. If a student has sustained a concussion, the student s brain needs time to heal. While a concussed student s brain is still healing, that student is much more likely to have another concussion. Repeat concussions can increase the time it takes for an already concussed student to recover and may cause more damage to that student s brain. Such damage can have long term consequences. It is important that a concussed student rest and not return to play until the student receives permission from an MD or DO, sufficiently familiar with current concussion management, that the student is symptom-free. How can students prevent a concussion? Every sport is different, but there are steps students can take to protect themselves. Use the proper sports equipment, including personal protective equipment. For equipment to properly protect a student, it must be: The right equipment for the sport, position, or activity; Worn correctly and the correct size and fit; and Used every time the student Practices and/or competes. Follow the Coach s rules for safety and the rules of the sport. Practice good sportsmanship at all times. If a student believes they may have a concussion: Don t hide it. Report it. Take time to recover.

9 I hereby acknowledge that I am familiar with the nature and risk of concussion and traumatic brain injury while participating in interscholastic athletics, including the risks associated with continuing to compete after a concussion or traumatic brain injury. Student s Signature Date / / I hereby acknowledge that I am familiar with the nature and risk of concussion and traumatic brain injury while participating in interscholastic athletics, including the risks associated with continuing to compete after a concussion or traumatic brain injury. Parent s/guardian s Signature Date / /

11 VOLUNTEER INFORMATION Thank you for allowing your son or daughter to participate in the amazing sport of ice hockey! Our organization is unique in that it is not a school sanctioned sport, but supported by the Hempfield Ice Hockey Club! This club exists solely due to volunteers, both parents and alumni who love the game and are committed to making sure that the Hempfield Ice Hockey tradition continues!! Without the Board and the many volunteers, the club would not exist. We are asking that each family volunteer for at least one task or committee. The volunteer opportunities and descriptions are listed below. Please sign up for one or more opportunities by putting your name by the jobs that you would help with this year! Player Name: Volunteer Opportunity Board Members CPIHL Representative Description Attend monthly meetings, potential to serve on the executive committee, participate in the oversight of club operations. Attends Monthly CPIHL meetings and provides a report of the minutes to the Board of Directors each month Name/ Contact Information Player Registrar Committee Assistant with on ice activities Team Manager Web Master Organizes Registration meetings and registration materials for Parent meeting. Assures that all registered players have provided all necessary forms, insurance information and USA hockey registration. Submits necessary forms to the CPIHL as regulated in order to roster Hempfield teams. Works with coaches, assistants and managers to assure all are registered with USA hockey. Submits all USA hockey registration numbers to the CPIHL, Notifies coaching staff if any players are ineligible to skate based upon missing documentation. Provides the club secretary, coaches, managers and all necessary individuals with final rosters, contact information. Submits the Drug and Alcohol forms to the Athletic Director of HHS and provides each team manager with copies of each player s registration packet. Head Coach determines the number of assistants as well as the role of each. Certifications required will be dependent upon level of responsibility. At least one per team. Responsible for organizing and coordinating activities associated with each team such as distribution of game schedules, signing players at games, assigning all game volunteers, assuring that all volunteers have sufficient clearances for jobs assigned, carrying all player information to each game in the event documentation is needed. Responding to coaching staff requests. Updates the organization s website wit game and practice schedules, player rosters and stats throughout the season. Works with the CPIHL representative to insure game stats recorded through Point Streak are accurate. Forwards discrepancies to the League in a timely manner.

12 Forwards announcements to appropriate schools prior to and immediately following each game. Apparel Grocery Card Committee End of Year Banquet Ad Book/ Program Committee Senior Night Ice Scheduler Game Day Volunteers Presents Uniform Information at the spring Registration meeting. Takes orders for all new uniforms needed. Places orders and distributes to team members. Organizes spirit wear orders, collects orders and payments then distributes merchandise. Works with the Banquet committee for end of year player gifts. Works closely with the treasurer to manage the Grocery Card program. Sells Grocery Cards, collects monies and reconciles the cards and monies on a monthly basis. Monthly report of Grocery Card activity is reported to the board through the treasurer report. Plans end of year banquet including date, location and menu. Determines the cost of non-participants to cover the overall banquet total. Organizes coaches and team gifts to be distributed the night of the banquet. Works with the Apparel committee to order the player gifts. Organize and plan production and printing of the yearly Ad Book. Presents information at the spring Registration meeting regarding the sale of Advertisements for the Ad Book. Organizes and plans Senior Night activities. Works with the Board of Directors in choosing the date and the budget. Works with the Ice Rink to establish practice Ice Slots for all Hempfield teams. Will notify the rink when practice slots will not be utilized. Work with Team Managers to be sure all duties are covered or each game. The duties include: Yellow Jackets serve as security for games 2 needed each game. Penalty box attendant- tends the penalty box opens and closes the door as needed. Clock Operator operates the game clock for home games.*are you trained or willing to be trained to operate clock? Scorekeeper keeps score and state sheets using PointStreak home games.*are you trained or willing to be trained on PointStreak? Announcer makes announcements during home games. Gate attendants collects entrance fees for home games. Must be at the table ½ hour before game time and remain at table until the end of the first period. Locker Room Attendant-Must obtain or have clearances through USA hockey. Must stand outside of the locker rooms at any time any child is in the locker room as per SafeSport guidelines. HIHC Board Meetings are held on the 4 th Tuesday, each month of the school year at Landisville Middle School 7:00 pm. During the summer months, the meetings are held at the home of one of the board members!! All are welcome to attend!! CPIHL meetings are held on the 2 nd Thursday of each month.

13 Hempfield Ice Hockey Club, Inc. Grocery Gift Card Sales Weis and Giant Grocery Gift Cards are available to purchase for $50 or $100 through the club. For each card you sell, 5% will be credited to your account. $2.50 is credited to your account for each $50 card sold. $5.00 is credited to your account for each $100 card sold. Grocery Cards can be bought year round. We encourage you to purchase them for yourself and also get family and friends to regularly purchase them from you. You will be surprised how quickly your account balance grows. It is possible to pay for most, if not all, of your club fees (season fees/jerseys & socks/apparel orders/end of season banquet) with grocery gift card money. You only need to notify the club treasurer to apply the amount in your account toward your fees. Grocery Gift Card Contact Persons

Player Information Today s Date:

Player Information Today s Date: www.thejrtigers.com Player Information City & Zip: Fall 2015 School: Fall 2015 Grade: Email address: www.sacyouthfootball.com Today s Date: Birth Date: Where did you play last year?: Parent(s)/Guardian(s)